PND79 HOW DIFFERENT ARE MIGRAINE PATIENTS TREATED BY GENERAL PRACTITIONERS VERSUS THOSE TREATED BY NEUROLOGISTS?

Abstract

To characterize patients with migraine managed by general practitioners versus neurologists. A worldwide, cross-sectional, online survey was conducted including migraine patients recruited via online panels and patient organizations from September 2017-February 2018. Study participants were adults reporting 4 or more monthly migraine days (MMD) over the 3 months previous to survey with a pre-determined quota of 90% participants having received previous preventive migraine treatment. Results from the Portuguese sample are reported for overall and for patients with two or more previous prophylactic treatment failures (TF2+). Hundred-eight Portuguese participants were included. Characteristics of overall (TF2+) participants managed by GPs (n=64) vs specialists (n=44) were: mean age 35.8 vs 40.2 years (36.7vs40.6), female 78% vs 75% (77%vs73%), +5 years of disease 66% vs 80% (77%vs78%), family history of migraine 63% vs. 64% (66%vs68%), average number of comorbidities 0.6 vs 1.1 (1.0vs1.2), anxiety 31% vs 39% (31%vs43%), depression 17% vs 39% (31%vs43%), mean MMD over last 3 months 9.5 vs 11.1 (9.6vs10.7), taking acute medication 70% vs 86% (69% vs 89%), TF2+ 55% vs 84%, number of current prophylactic treatments 1.4 vs 2.0 (1.6vs2.2), taking betablockers 36% vs 25% (34%vs24%), taking antidepressants 23% vs 45% (37%vs51%), taking antiepileptics 17% vs 43% (20%vs49%), dissatisfied with preventive treatment 18% vs 8% (14%vs8%), at least one emergency visit over last 12 months 52% vs 57% (60%vs62%), out of pocket expense average €101 vs €156 (€136vs€181), employed 73% vs 80% (77%vs81%), missed work over last month 45% vs 66% (34%vs51%). Migraine patients treated by specialists are on average 4.4 years older than patients treated by GPs, have higher mean number of comorbidities, higher prevalence of depression, higher proportion with two or more prophylactic treatment failures, are more prone of being in treatment with antidepressants or antiepileptics, spend more with out-of-pocket expenses and higher proportion of missing work.